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PTSD

When I came to Europe, I wasn’t sure how long I would stay. I brought enough medication to last three months (the most I could). By the time it ran out, I was already making plans to return to Turtle Island and figured I could get free refills if I waited. I have been waiting a long time now. Emergencies keep coming up that prevent me from having enough money to leave.

I was able to borrow other prescriptions, but the one thing I couldn’t find was my SSRIs (selective serotonin re-uptake inhibitors — a common genre of antidepressants), specifically citalopram (celexa). I had previously considered discontinuing them anyway, but I knew it was dangerous, especially when my situation and my (mental) health are already so precarious. There was always some life-threatening crisis, constant brushes with death, and crushing poverty, so it never seemed like the right time to add another potential hazard. Plus, I had more pressing chemical dependencies to deal with first.

So when I started to run out of them, I figured it was as good a time as any to go off them. I knew the risks when I started taking my SSRIs years ago. So before I quit, I read as much as I could. I tapered my doses downward over a period of months. It has now been several weeks since I stopped taking them entirely and I feel like shit.

I didn’t immediately recognize the creeping, inexplicable (and therefore terrifying) symptoms as SSRI withdrawal. When I first realized it was connected, I was a bit relieved because it seemed to show it was a transitory chemical readjustment. But it kept getting worse and worse and I started to fear something was very wrong, that it must be something else. But the more I looked into it, I found that the scary truth seems to be that this kind of suffering is a relatively normal thing during SSRI withdrawal.

Before I posted my newest story (What’s Left When Coping is Killing Me?), I spent days editing it. I had to vividly relive the experiences I was writing about. Also, it was extremely hard to share those parts of my life — especially my recent drug use. Until that post, that was one of the few remaining things I wasn’t “out” about. On top of stress about housing, finances, and the continued spike in violence against trans women in D.C., my anxiety was off-the-charts.

I give off confident vibes, and I share most aspects of my identity/history freely. However, being so visible and exposed is extremely draining and occasionally terrifying. People recognize me on the metro. I’ve received death threats on my cell phone. I don’t live in a protected, academic bubble — I’m a crazy, low-income tranny punk and a sex worker. Being out has serious consequences.

Recently, when I admitted to my therapist that I had lost the desire to live, I was nearly hospitalized. It was a brutal wake-up call — both to how bad off I was, and how I am not immune to the constant threat of medical surveillance and even incarceration. After sharing my story about this, I mostly received praise and support. But a few folks recommended various ways to “get rid of my anxiety” or “cure my depression/addictions/etc.” I think it’s worth unpacking their assumptions.

Most neurotypical people assume I want to or should change those aspects of myself. This ends up reinforcing much of the ableist ideologies that contributed to my being in that situation to begin with. A lot of this also had to do with judgement (outright or subtle) around the use of ‘hard’ drugs. I want to clarify/reinforce some of the things I was trying to say, and why I said them. So I decided to write about what publishing that story felt like. It evolved into a meditation about how I experience my mental illness — personally and politically — as a disability, and growing into my identity as a proudly mad, disabled person. I’m not necessarily glad to be so crazy; it makes my life very hard and has led to untold suffering. But there is a different between being glad and being proud.

I look at how ableism divides the world into “normal” and “disabled” people by making much of life inaccessible for people with physical and/or psychiatric impairments. I also explore the problem of countering false narrative of personal responsibility (“drug addiction is a choice”) with the need to value autonomous decision-making. Finally, I look at ways that being crazy can be a gift and a weapon that, when re-directed away from our selves, can destroy the social conditions which keep us from healing.(more…)

This is an account of the days leading up to and following the murder of a young trans woman of color in my community. It is also about falling in love, and how my anxiety and panic are intertwined with an internalized acceptance of my own social marginalization, especially relating to drug use and sex work. Finally, it is about my conflicted (sometimes irrational, self-destructive) strategies for surviving those things.

I wrote it awhile ago during a very dark time. I had to wait for the wounds to heal a bit before I let people read it. They are still raw, and it’s still hard for me to say these things. It’s especially hard to admit my recent addictions. There’s a lot of judgment around being poor, trans, crazy, and a sex worker — but for whatever reason, that derision is easier for me to shake than the bullshit drug users have to put up with. But I think sharing it will help. I hope it means as much to someone else as it does to me.

It is a hard read. It has already made people cry. When I wrote it, I was very lost. I was facing so many tragedies that I couldn’t see the blessings. If you’re looking for something to give you hope, this is not it. This is a story about how sometimes, even when I have completely lost all hope, I just keep going — simply because I just don’t know what else to do.

It ends somewhat ambiguously, because that is honestly how I felt at the time. I still don’t have an answer to the question that is both the title and subject of this essay: How can I rationalize continuing to live when the pain always seems to outweigh the good, and when my coping mechanisms for dealing with that pain are often causing more harm?

As someone who is diagnosed with post-traumatic stress disorder, I sometimes feel like there is an expectation that my symptoms can be easily traced to one cause. Unlike some “mental illnesses”, where biologically deterministic theories reign supreme, PTSD is most closely associated with particular life experiences. PTSD is what happens after a car bomb blows up part of your convoy, or an earthquake shatters your windows.

I’ve felt this pressure — from friends, psychiatrists, and myself — to explain my PTSD as something caused by a singular event. Most commonly, I point to the time I was jumped just outside of my house. That was not the first extremely violent situation that ever happened to me; the first time of many I was queer bashed was when I was 13. But because this is the most recent, and because I have to walk by where it happened almost every day, it’s this one time that I feel most often in flashbacks and that continues to haunt me most severely.

However, I don’t think this is a very helpful way of looking at PTSD, at least not for me. It’s really impossible for me to isolate one event from the entire context of my life and say “this is what caused it.” The concept of Complex PTSD is a proposed diagnostic category that begins to get at this – it would be used to describe trauma from prolonged situations, such as “chronic maltreatment by caregivers” (which I also experienced, and I believe most trans people who had transphobic parents could potentially be placed under this). C-PTSD is the result not of one traumatic event, but rather a pervasive state of powerlessness and abuse. It was first noted as occurring in prisoners of war, survivors of genocidal atrocities, and child sexual abuse survivors.

I wrote a few pages about the day I applied for food stamps from the vantage point of a trans woman, sex worker, burnt-out activist, and crazy person. It is an autobiographical reflection on what it means to struggle not only against unjust social conditions and poverty, but also against complex internal forces we call “mental illness” for simplicity. (And how the two reinforce one another.)